Chandigarh: Following the Supreme Court’s latest ruling on passive euthanasia, the guidelines and expert committee formed by PGI back in 2009-10 once again became a subject of intense discussion.Nearly 15 years ago, PGI established a clear procedure for making decisions in such cases, ensuring that medical and ethical factors were balanced for patients on long-term life support.Harish Rana (32), for whom the Supreme Court recently granted permission to withdraw life support, was admitted to PGI following a severe accident in Chandigarh in 2013. He underwent extensive treatment there for a long period in a critical condition.Dr S K Jindal, the former head of the department of pulmonary medicine, noted that PGI’s expert committee developed these guidelines between 2009 and 2010. The objective was to create a transparent process for situations where a patient is on a ventilator for an extended period and doctors believe the chances of recovery effectively vanished.According to the guidelines, making a decision on “Withdrawal of Life Support” involves a rigorous multi-step process. If a family requests passive euthanasia, the written consent of at least two immediate family members is mandatory. A team of specialist doctors assesses the patient’s clinical status to confirm whether the condition is permanently irreversible. The decision is not made by a single doctor, but involves experts from various depts who reach a collective conclusion.Only after considering all medical and ethical aspects is the process of withdrawing life support initiated.A former department head at PGI revealed that during the youth’s long stay at the institute, the option to withdraw life support was discussed among experts due to the severity of his injuries. However, at that time, the family did not agree, and treatment continued.“The Supreme Court’s latest decision reignited the conversation around the right to die with dignity. In such complex situations, clear guidelines like those developed by PGI serve as a vital roadmap for both medical professionals and grieving families,” said a faculty member at PGI.BOX:In his publication, “End of Life Care”, in the Journal of Postgraduate Medicine Education and Research in 2012, Dr Jindal mentioned that the core medical philosophy for terminal care should remain “Exit with dignity.” The publication warned that families are often “economically ruined” by the huge costs of ICU care for patients with no hope of recovery. Dr Jindal observed that technological advances created a belief that life could be “prolonged at will”, often resulting in life-supporting measures that were “antagonistic to the very dignity of life”.
